参芪扶正注射液联合环磷腺苷葡胺治疗慢性心力衰竭的临床观察

目的:探讨参芪扶正注射液联合环磷腺苷葡胺治疗慢性心力衰竭(CHF)的疗效及对肌钙蛋白T(c Tn T),类胰岛素生长因子-1(IGF-1)和同型半胱氨酸(HCY)的影响。方法:将86例CHF随机按住院前后分为对照组和观察组各43例。两组均采用常规非药物和药物疗法,药物使用包括服用氢氯噻嗪片,25~50 mg/次,2次/d;卡托普利片,12.5 mg/次,2次/d;酒石酸美托洛尔片,50~100 mg/次,2次/d;地高辛片,0.25 mg/次,1次/d,必要时服用。对照组采用注射用环磷腺苷葡胺,120mg/次,静脉滴注,1次/d。观察组在对照组治疗的基础上加用参芪扶正注射液,250 m L/次,静脉滴注,1次/d;两组疗程均为2周。采用超声心动图检测治疗前后心功能;检测治疗前后N末端前脑利钠肽(NT-pro BNP),c Tn T,IGF-1和HCY水平。结果:经Ridit分析,观察组疗效优于对照组(P<0.05);治疗后观察组左室射血分数(LVEF),每分钟输出量(CO)和每博输出量(SV)高于对照组(P<0.01);治疗后观察组NT-pro BNP,c Tn T和HCY水平低于对照组(P<0.01),IGF-1水平高于对照组(P<0.01)。结论:参芪扶正注射液联合环磷腺苷葡胺能提高CHF患者LVEF,CO,SV,对心功能有明显的改善作用,其作用机制可能是通过提高IGF-1水平,降低NT-pro BNP,c Tn T和HCY水平来实现的。

Clinical Observation of Shenqi Fuzheng Injection Combined with Meglumine Adenosine Cyclphosphate in Treating Patients with Chronic Heart Failure

Objective: To discuss the curative efficacy of Shenqi Fuzheng injection united meglumine adenosine cyclphosphate in treating chronic heart failure (CHF) and to investigate its influence on troponin T(cTnT), insulin-like growth factor 1(IGF-1) and homocysteine (HCY). Method: Eighty-six patients with CHF were randomly divided into control group (43 cases) and observation group (43 cases). Patients in both groups received conventional non-drug and drug therapies. Drug therapy included 25-50 mg hydrochlorothiazide tablets, 12.5 mg captopril tablets, 50-100 mg metoprolol tartrate tablets twice daily, and 0.25 mg digoxin tablets once daily when needed. Patients in control group received intravenous drip of 120 mL meglumine adenosine cyclphosphate injection once daily. Based on the treatment of control group, patients in observation group added intravenous drip of 250 mL Senqi Fuzheng injection and 120 mg mixture meglumine adenosine cyclphosphate once daily. Patients in two groups received 2-week treatment. Cardiac function was tested by adopt echocardiogram before and after treatment. Levels of N terminal pro-brain natriuretic peptide (NT-proBNP), cTnT, IGF-1 and HCY were detected before and after treatment. Result: By Ridit analysis, the curative effect of observation group was superior to that of control group (P<0.05). The levels of left ventricular ejection fraction(LVEF), output per mimute(CO) and stroke volume(SV) of observation group were higher than those of control group (P<0.01). Levels of NT-proBNP, cTnT and HCY in observation group were less than those in control group (P<0.01), while the IGF-1 of observation group was superior to that of control group (P<0.01). Conclusion: Using Senqi Fuzheng injection combined with meglumine adenosine cyclphosphate could enhance the levels of LVEF, CO, SV in CHF patients and improve heart function significantly. Its mechanism may related to improving IGF-1 level and reduce the NT-proBNP, cTnT and HCY levels.